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Marcus Malek, MD director of Pediatric Surgical Oncology at UPMC Children’s Hospital of Pittsburgh, directs a unique research program focused on improving surgical outcomes in pediatric tumors through use of novel molecular imaging technology. Towards this end, he and his lab team are developing new surgical tracers to guide surgeons to the tumor, facilitate safe resection, and confirm that the entire tumor was removed.
Complete surgical resection of tumors is critical to providing the best possible patient outcomes, but unfortunately, incomplete resection is a common occurrence. A significant program being pursued by Dr. Malek and his team is a dual-labeled, tumor-specific tracer, that will provide both visual and audible signals within the tumor that can be detected using existing surgical tools. Although the project is specifically targeting pediatric neuroblastoma and osteosarcoma, ultimately the technology can also be applied to other types of pediatric tumors.
Despite rapid advancements and use of surgical tracers for adult tumors, surgical tracer development for resection of pediatric cancers has been limited. Researchers in the Malek Lab are seeking to improve pediatric cancer surgery outcomes through development of a first-of-its-kind tracer that incorporates tumor-specific targeting, radioactivity for guidance to hidden tumors, and fluorescence for visualization of exposed tumor. This research focuses on pediatric solid tumors, including neuroblastoma, surgery for which has a complication rate of nearly 50%, due in part to deep lesions that are often difficult for surgeons to discern from normal tissue. Researchers believe that a radio-fluorescent antibody-based tracer can facilitate intraoperative detection of pediatric neuroblastomas for safer and more complete removal, leading to improved patient outcomes and survival. Similarly, metastatic osteosarcoma can often be challenging to find, but complete tumor removal is critical to survival. A radio-fluorescent tracer could prove invaluable for these patients.
Some of the handheld tracer devices used in the Malek Lab’s research.
Pulmonary nodules have various etiologies, and thoracoscopic biopsy is typically used for diagnostic and therapeutic resection in children. However, subpleural and subcentimeter lesions can be extremely difficult to visualize. The Malek Lab is leading a multi-center study to evaluate the extent to which image-guided localization techniques can assist in detection of pulmonary nodules.
The use of indocyanine green (ICG) provides a fluorescent cue for identifying pulmonary nodules during thoracoscopic surgery.
Principal Investigator marcus.malek@chp.edu Read More>>
Gary Kohanbash, MD Co-investigator gary.kohanbash@chp.edu
Barry Edwards Co-investigator wbe2@pitt.edu
Lauren Rosenblum MD, PhD Post-Doctoral Fellow rosenblumlt@upmc.edu
Sever, ReidAnn Research Technician
The Malek Lab UPMC Children’s Hospital of Pittsburgh John G. Rangos Sr. Research Center, Suite 8129 4401 Penn Avenue Pittsburgh, PA 15224 412-692-7291 marcus.malek@chp.edu
Marcus Malek, MD, and Gary Kohanbash, PhD, were awarded R01 funding by the NIH and NCI for their project titled "Intraoperative dual-labeled molecular tracer to improve surgery on neuroblastoma".
Marcus Malek, MD, was awarded the R.K. Mellon Institute Pilot Translational Research Award for his project, “Development of a Targeted Radio-fluorescent Tracer for Intraoperative Detection of Occult Malignant Lesions and Tumor Margins, Facilitating Complete Surgical Resection of Pediatric Tumors.”
Dr. Malek presented his work on dual-modality intraoperative molecular imaging in neuroblastoma at the Precision Surgery international meeting in Philadelphia, PA.
Katrina Morgan, MD, gave a platform presentation entitled, “Interhospital Variability in Localization Techniques for Pulmonary Nodules in Children: A Pediatric Surgical Oncology Research Collaborative study,” at the American Academy of Pediatrics Virtual National Conference & Exhibition.
Handheld PET Probe for Pediatric Cancer Surgery Rinehardt HN, Longo S, Gilbert R, Shoaf JN, Edwards WB, Kohanbash G, Malek MM Cancers 2022 Apr 29
Thoracoscopy vs Thoracotomy for the Management of Metastatic Osteosarcoma: A Pediatric Surgical Oncology Research Collaborative Study Lautz TB, Farooqui Z, Jenkins T, Heaton TE, Doski JJ, Cooke-Barber J, Murphy AJ, Davidoff AM, Mansfield SA, Kim ES, Zuber S, Goodhue C, Vasudevan SA, LaQuaglia MP, Piche N, Le-Nguyen A, Aldrink JH, Malek MM, Siow VS, Glick RD, Rich BS, Meyers RL, Short SS, Butter A, Baertschiger RM, Fialkowski EA, Dasgupta R International Journal of Cancer 2021 Mar 1
Microcoil Localization as an Effective Adjunct to Thoracoscopic Resection of Pulmonary Nodules in Children Morgan KM, Crowley JJ, Many BT, Lautz TB, Malek MM Journal of Pediatric Surgery 2021 Jan
Minimally Invasive Surgery for Abdominal and Thoracic Neuroblastic Tumors: A Systematic Review by the APSA Cancer Committee Gurria JP, Malek MM, Heaton TE, Gehred A, Lautz TB, Rhee DS, Tracy ET, Grant CN, Baertshiger RM, Bruny J, Christison-Lagay ER, Rodeberg DA, Ehrlich PF, Dasgupta R, Aldrink JH Journal of Pediatric Surgery 2020 Nov
Minimally Invasive Surgery for Pediatric Renal Tumors: A Systematic Review by the APSA Cancer Committee Malek MM, Behr CA, Aldrink JH, Dasgupta R, Heaton TE, Gehred A, Lautz TB, Baertschiger RM, Christison-Lagay ER, Tracy ET, Rhee DS, Rodeberg D, Austin MT, Ehrlich PF Journal of Pediatric Surgery 2020 Nov
Optimization of Percutaneous Biopsy for Diagnosis and Pretreatment Risk Assessment of Neuroblastoma Overman RE, Kartal TT, Cunningham AJ, Fialkowski EA, Naik-Mathuria BJ, Vasudevan SA, Malek MM, Kalsi R, Le HD, Stafford LC, Lautz TB, Many BT, Jones RE, Bütter A, Davidson J, Williams A, Dasgupta R, Lewis J, Troutt M, Aldrink JH, Mansfield SA, Lal DR, Xiao J, Meyers RL, Short SS, Newman EA Pediatric Blood & Cancer 2020 May
Contrast-Enhanced Ultrasound of Congenital and Infantile Hemangiomas: Preliminary Results from a Case Series El-Ali AM, McCormick A, Thakrar D, Yilmaz S, Malek MM, Squires JH AJR American Journal of Roentgenology 2020 Mar
Use of Intraoperative Nuclear Imaging Leads to Decreased Anesthesia Time and Real-time Confirmation of Lesion Removal Fusco JC, Seynnaeve BKN, Davit AJ 3rd, Czachowski MR, Joyce JM, Gaines BA, Malek MM Journal of Pediatric Surgery
The Malek Lab is looking for talented post-doctoral fellows and graduate students interested in Intraoperative Molecular Imaging and Pediatric Cancer Surgery. Please contact Dr. Marcus Malek via email at marcus.malek@chp.edu if you are interested.
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